MS-N170 · Exercise and rehabilitation · adult cancer survivors with persistent CIPN at least six months after chemotherapy
Evidence at a glance
- Question: Is a 10-week remotely delivered exercise-rehabilitation program feasible, safe and effective for persistent chemotherapy-induced peripheral neuropathy?
- Finding: Feasibility and acceptability were encouraging, but later retention missed targets and the single-arm design cannot establish efficacy.
- Evidence label: Feasibility signal; efficacy unproven
- Benefit: Symptoms and disability improved over time among completers, without a control group.
- Certainty: Very low for benefit; stronger for short-term feasibility and mild-event characterization.
- Risk: Nine grade-1 program-related events; no grade-3 or higher program-related event.
- Cancer-control boundary: Neuropathy symptom changes do not demonstrate cancer control.
What was studied
EX-CIPN enrolled survivors with neuropathy symptoms at least six months after curative-intent neurotoxic chemotherapy who were doing less than 90 minutes of moderate exercise weekly.
- Design and comparator: Phase I, single-center, single-arm mixed-method feasibility study; no randomized comparator.
- Participants: 40 consented and 36 provided baseline demographic data; 83% were women, with breast and ovarian cancers most common.
- Intervention: Ten weeks of individualized remote aerobic, resistance and flexibility training plus hand/foot strengthening, desensitization and nerve-flossing exercises, supported by five videoconference visits.
- Primary outcome and follow-up: Accrual, retention, adherence, acceptability and CTCAE safety; symptom and disability measures were secondary through 22 weeks.
What the study found
Baseline retention was 90%; retention fell to 68% after the program and 63% at three-month follow-up, below the prespecified 70% target. Adherence was 96% for coaching calls, 77% for aerobic goals and 85% for resistance/flexibility work. CIPN-20 and disability scores improved among those assessed, but without a comparator regression to the mean, natural recovery and selective retention cannot be excluded.
Negative or uncertain findings: Later retention targets were missed. The study was not designed or controlled to establish treatment efficacy.
Limits and applicability
Small, single-center and predominantly female sample; only completer trajectories were available for much of the symptom analysis. Participants with some neurologic conditions or unsafe exercise risks were excluded.
Funding and conflicts: Cancer Research Society grant 1276376. No commercial sponsor was identified in the extracted report.
Safety context
Four participants reported mild leg/back soreness, three foot/ankle/heel discomfort, one calf cramp and one fatigue; all resolved. Neuropathy raises fall and foot-injury risk, so balance, footwear, skin checks and individualized progression matter.
Questions for the care team
- Could another cause of neuropathy—diabetes, B12 deficiency, spine disease or medication—be contributing?
- Would supervised balance or gait assessment be safer than unsupervised exercise?
- What worsening pain, weakness or falls should trigger reassessment?
Primary sources
Last literature search: 29 October 2026. Record appraisal: 29 October 2026. This page is educational and does not replace individualized medical advice. Exercise prescriptions should be adapted to diagnosis, treatment, surgical restrictions, blood counts, cardiopulmonary status, neuropathy, fall risk and bone-metastasis location. Symptom or fitness improvement is not proof of tumor response, recurrence prevention or longer survival unless those outcomes were directly tested.
